As a new parent, you probably have heard lots of car seat safety information from family and friends. And you’ve read lots of conflicting information in online groups and from blogs. Well, fret not! As a certified Child Passenger Safety Technician, I am here to help you navigate it all.
According to Safe Kids Worldwide, over half of all car seats are being used incorrectly. Motor vehicle collisions are the leading cause of accidental death in children under 13. This means we are seeing more injuries and fatalities than we would if all seats were installed correctly. If you need help using your particular car seat, you can search for a local Child Passenger Safety Technician or set up a virtual appointment with me.
1. You Must Have a Car Seat When Leaving the Hospital
The American Academy of Pediatrics released a statement in 2015 clarifying that before the discharge of mother and child the hospital should ensure that “an appropriate car safety seat is available, and the mother is properly trained on positioning and use.”
With this in mind it’s a good idea to get the car seat well before your due date so you can have it properly installed and practice using it.
2. Use the Pinch Test to Check the Harness
The Pinch Test is the best way to check the tension on the car seat harness to make sure it’s not too tight or loose. We moved away from putting fingers under the harness to check for tightness because everyone’s hands are a different size. With the Pinch Test, if you can’t pick up any of the harness webbings between your thumb and pointer finger the harness is tight enough but not too tight.
To perform the Pinch Test:
- Tighten the harness as tight as you think it needs to be.
- Place your first finger and thumb on top of the harness webbing.
- Move your fingers together and try to pick up, or pinch, the webbing between them.
- If you can pick up the webbing, tighten a little more, and start again.
- If you cannot pick up the webbing, then the harness is tight enough.
3. Do Not Buckle the Baby in with Bulky Clothing or Puffy Jackets
Bulky clothing and jackets play a role in car seat safety. When we talk about tightness, you want to ensure the harness is as close to the child’s body as possible. Most jackets are filled with polyester filling that would flatten in the case of sudden impact in a car accident and should not be used in car seats as this introduces air/space between the child and their harness. Bulky clothing can also compress in a collision and create space between the harness and the child. Ill-fitting knits and snowsuits can cause the same issues.
Instead of using bulky clothing/jackets, use thin tight layers. A newborn needs only one more layer than you have on. Older kids can have a couple of layers on and take their jackets off when they get to the car seat. If it’s cold, you can buckle them in without the jacket on and then lay the jacket over the harness.
To check if a coat or other item of clothing is too bulky, you can follow these steps:
- Place your child in the car seat with the item of clothing/jacket in question on.
- Buckle and tighten the harness to pass the Pinch Test.
- Unbuckle, and without loosening the harness, take your child out.
- Remove the item of clothing in question and place the child back in the car seat.
- Re-buckle the harness and check to see if the harness still passes the Pinch Test.
- If it passes the Pinch Test, the item is fine to use in the car seat. If it doesn’t pass, then the item cannot be used.
4. Do Not Use Non-Approved Accessories with Your Car Seat
As cute as they may be, those strap covers with the elephant on them or those really fluffy head huggers are considered non-approved products. Experts don’t recommend using these items in a car seat unless they either came with the seat or the car seat manufacturer approves its use.
Chicco (Key-Ko) doesn’t approve any aftermarket products to be used with their car seats, even though there are some with their name on them. Chicco approves use of items that come in the box with the car seat but nothing more. Some manufacturers like Evenflo, Britax, and Clek allow use of aftermarket products that are approved and made by them specifically for their products.
5. Keep Your Child Rear Facing For As Long As Possible
Rear Facing is by far the most beneficial thing that you can do for your child in a vehicle. Rear-Facing protects the head, neck, and spine of a child. In a frontal collision, the head and neck of a young child who is forward-facing would not be able to sustain the crash forces. When rear-facing in the same frontal collision, the child is pushed into the car seat and moves with it, and the car seat takes the brunt of the crash forces. The crash forces are spread along the backside of the seat and the child’s head, neck, and spine remain in a relatively straight line.
Some states have laws that state children must remain rear-facing until at least age 2. Some states have what is called “proper-use” clauses, which say you must follow the manufacturer’s instructions. For example, if you live in a “proper use” state and you have an Evenflo convertible car seat, you must rear face until age 2, since this is a requirement for forward-facing in that seat.
The American Academy of Pediatrics (AAP) says to rear face until the upper height or weight limits of the seat are met. This statement was updated in August of 2018 after the study that cited children were safer rear-facing through the second year of life was retracted by the British Medical Journal. The National Highway Traffic Safety Administration (NHTSA) recommends rear-facing for as long as possible as well.
6. Top Tether Use (Forward Facing)
On all forward-facing seats in the US and Canada, there is a set of Lower Anchors and Tethers for CHildren (LATCH). While most people are familiar with the lower anchors, Safe Kids found that 64% of families are not using the tether while forward-facing. Many parents and caregivers are just unfamiliar with the benefits of using the top tether for a forward-facing car seat. The top tether can reduce forward head movement (called excursion) by 4-6 inches. Because the back seat of most passenger vehicles is quite small, that 4-6 inches of reduction in forward movement can be the difference in your child’s head hitting the front seat or not.
Ohio State’s Buckle Up with Brutus has a few good videos on YouTube and one specifically about the benefits of tethering your forward-facing car seat.
7. Booster Readiness
One of the most common questions I get is when to move from a harness to a booster and if there is a difference between a high back booster and a backless booster. There is not a hard and fast time to move your child to a booster.
I recommend harnessing until your child is at least 5 years old and 40 pounds. However, your child also needs to have the maturity to sit correctly for the entire car journey every time, even while sleeping. It’s not safe for small children to lean out of the seatbelt because their skeletons are not fully formed. The seatbelt is important in helping to protect children with an underdeveloped skeleton in a collision.
As for the difference between a high back booster and a backless one, there isn’t any safety difference. A high back booster offers some side-impact protection where a backless one does not. A high back booster seat should always be used if the vehicle doesn’t have a head restraint (headrest). I always recommend that a child who is new in a booster have a high back booster as it reminds them to remain upright. Plus, the headwings will give them a place to rest their head if they fall asleep.
8. When To Move From Booster To Seatbelt
Children should remain in a booster seat until 5 conditions are met:
- They can sit with their back against the vehicle seat.
- Their knees bend naturally at the edge of the seat.
- Their feet touch the floor.
- The seat belt fits across their body correctly. The lap belt should be low on the hips, touching the upper thighs. The shoulder belt should be hitting the clavicle between their neck and their shoulder. The shoulder belt should be touching their collar bone.
- This position can be maintained for the entire ride.
Moving a child to a seatbelt too soon could result in seatbelt syndrome in a collision. Most children are not ready for a seatbelt until they are between 10 and 12 years of age. The adult seatbelt is designed to fit adult males who are about 4’9”. While this is a general height, there are some situations that a child may 5-step before that height in some seating positions in some vehicles. There are also situations where an older child may need a booster in some vehicles for longer than others.
9. Checking Car Seat Installation Tightness
The most common question I get besides “what is the best car seat?” is “how do I know my car seat is installed correctly?” I always say to read the manual to learn how to install the car seat. Generally, you can install a car seat with either the lower anchors or the seatbelt. When properly installed, the car seat should not move more than one inch side-to-side or front-to-back when checking where the lower anchor strap or the seatbelt goes through the seat (also called the belt path). When checking for movement, you want to grip the edge of the car seat near the belt path and push and pull sideways with moderate force and front-to-back with moderate force.
10. Expiration Dates
Car seats expire?! They sure do. Most car seat manufacturers have expirations on their car seats between 6 and 10 years. There are some outliers, of course, but this is a good general range. Some manufacturers list the expiration date on the label of their car seats and some list it in the manual. Others etch it into the plastic molding of the car seat itself. If you’re not sure when your car seat expires, you can usually find this information in the FAQ on the manufacturer’s website.
So why do car seats expire? Generally, car seats expire because technology has moved on, safety standards and regulations have changed, plastics and other materials degrade over time, and replacement parts may no longer be available.
A few more tips
Read the Manual
Your manual will always tell you what is appropriate and what is not per your car seat manufacturer. The manual will show you how to install, go over limits for use of the car seat, provide warnings about your car seat, and often tells you the expiration date of the car seat, too! If you have lost your manual, almost all car seat manuals can be found on the car seat manufacturer’s website.
Safe Sleep and the Risk of Positional Asphyxia
Car seats are not safe sleeping surfaces. You should always move your child to a safe sleeping surface at your earliest convenience. While it’s normal for babies and kids to fall asleep in the vehicle, it’s not safe to put them to sleep in a car seat outside of the vehicle or a designated stroller that is compatible. In the vehicle and the stroller, the car seat is at the correct recline designed to protect the airway. Outside of the vehicle, we do not have that same protection of the correct recline.
Vehicular heatstroke is a growing concern among CPSTs like me. We have seen a steady increase in people leaving their children in vehicles accidentally. We want to limit this risk.
Everyone is susceptible to leaving their child in the vehicle. This is not a dig at your parenting. It’s something we have seen happen to the best parents and to people who do not think that it can happen to them.
For parents who work, have you ever been at work and said that you need to get milk on the way home from work? And then when you leave work and get in your car, you seemingly blink and you’re at home? You are in your driveway and forgot to stop at the store on the way home. It’s as easy as that. A change in routine, circumstance, exhaustion, and not being in the moment are all reasons that you could “forget” your child is in the vehicle with you. Be proactive and think of a way to remind yourself to check the backseat every single time you get out of the vehicle.
There are a few car seats on the market (Evenflo and Cybex) that have a reminder technology called SensorSafe. This technology works with your vehicle’s diagnostic port to alert you that there is a child in the vehicle. For those of us who don’t want to go buy a new car seat for this technology, there are other things you can do to remind yourself.
Baby In Car Lanyard has a buckle tongue attached to it that goes into the car seat when it’s not occupied and around your neck when the car seat is occupied. You can also put something that you need to start your day, like your purse or phone, in the backseat to remind you to check the backseat. Always #lookbeforeyoulock and #lockbeforeyouleave.